Exploring the capacity to ambulate after a period of prolonged mechanical ventilation

Purpose: The purpose was to assess the functional recovery of those who survived a prolonged intensive care unit (ICU) stay by reporting the proportion who were able to ambulate independently at hospital discharge and also to examine if the time duration between admission and when the patient first stood impacted on their capacity to ambulate at discharge. Materials and Methods: We conducted a retrospective review of medical records of ICU patients in 2007-8, mechanically ventilated for ≥ 168 hours and surviving their acute care stay. Main outcome measures were: (i) ambulation status prior to admission and at time of hospital discharge; (ii) time between admission to the ICU and when the patient first stood. Results: A total of 190 patients were included. Prior to admission 189 (99%; 95% confidence interval [CI], 98 to 100%) were ambulating independently, of whom 180 (95%) did not require a gait aid. On discharge from acute care 89 (47%; 95% CI, 40 to 54%) were ambulating independently, of whom 54 (61%) did not require a gait aid. Compared with those who stood within 30 days of ICU admission, a delay in standing of between 30 and 60 days increased the odds five-fold (95% CI, 2 to 11) of being unable to ambulate independently at the time of discharge. Conclusions: Following a prolonged ICU admission more than 50% of patients were unable to ambulate independently by hospital discharge, with the time between admission and first stand, being an important predictor of this outcome